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Individual
BRENT N FULTON
Active
Individual
BRENT N FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME94759
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME94759
FL
Other
Enumeration date
11/21/2005
Last updated
09/20/2024
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